Br J Sports Med 41:469-480 doi:10.1136/bjsm.2006.033548
  • Review

Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review

  1. R N van Gent1,
  2. D Siem1,
  3. M van Middelkoop1,
  4. A G van Os1,
  5. S M A Bierma-Zeinstra1,
  6. B W Koes1
  1. 1Erasmus MC Rotterdam, Netherlands
  1. Correspondence to:
 Marienke van Middelkoop
 Erasmus MC Rotterdam, Dr Molewaterplein 50, Rotterdam, Netherlands; m.vanmiddelkoop{at}
  • Accepted 13 March 2007
  • Published Online First 1 May 2007


The purpose of this study was to present a systematic overview of published reports on the incidence and associated potential risk factors of lower extremity running injuries in long distance runners. An electronic database search was conducted using the PubMed–Medline database. Two observers independently assessed the quality of the studies and a best evidence synthesis was used to summarise the results. The incidence of lower extremity running injuries ranged from 19.4% to 79.3%. The predominant site of these injuries was the knee. There was strong evidence that a long training distance per week in male runners and a history of previous injuries were risk factors for injuries, and that an increase in training distance per week was a protective factor for knee injuries.


  • Published Online First 1 May 2007

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